doctHERS-in-the-House

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doctHERS-in-the-House

PakistanKarachi, Pakistan
Year Founded:
2013
Organization type: 
nonprofit/ngo/citizen sector
Project Stage:
Start-Up
Budget: 
$10,000 - $50,000
Website:
http://www.docthers.com
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Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

DoctHERS-in-the-House: • Creates opportunities for female doctors who can not access the workplace to practice their profession from home • Provides access to healthcare for millions of women and families in marginaized communities • Offers Innovative approaches to healthcare delivery via technology • Provides a platform for entrepreneurial activities, training, mentorship and a network for healthcare communities

WHAT IF - Inspiration: Write one sentence that describes a way that your project dares to ask, "WHAT IF?"

We were able to connect thousands of qualified female home-based doctors who can not access traditional workplaces to millions of marginalized women who desperately need care but can not access quality, affordable healthcare via technology?
About Project

Problem: What problem is this project trying to address?

80% of all medical school graduates in Pakistan are women, yet only 25% ever practice due socio-cultural constraints. In the same Pakistan, 95% women living in poverty can not access affordble care and have never seen a qualified doctor. Stuck in this crisis, millions of marginalized women face unnecessary high maternal-child mortality/morbidity, sadly in the presence of promising doctors. All the while, the same Pakistan boasts 85% penetration of mobile access to mobile & internet technology. Given the significant demad-supply mismatch between doctors and patients, it behooves us to question how we can use technology to bridge this gap?

Solution: What is the proposed solution? Please be specific!

DIH is a novel healthcare marketplace that connects female doctHERS to millions of underserved patients in real-time while leveraging technology. DIH circumvents socio-cultural barriers that restrict women to their homes, while correcting two market failures: access to quality healthcare and gainful employment. DIH leapfrogs traditional market approaches to healthcare delivery and drives innovative, sytems change. For example: • doctHERS can access urban /rural patients through mobile and internet enabled technologies/vídeo-conferencing • Trained, trusted community Nurses/ Health Workers/Midwives assist DoctHERS in assessing patients at ‘point-of-care’ using diagnostic tools which creates a new ‘healthcare value chain’ • doctHERs can work across the healthcare sector: operate 24/7 tele-healthlines, conduct medical/claims reviews, contract services to health plans (PPOs, health insurance companies), promote health/wellness coaching and trainings via web, IVR-enabled health modules or SMS-enabled localized health messaging • DIH can leverage mobile banking technology to provide a cashless, digital payment solution to collect all user fees • DIH can include thousands of qualified female doctors in the Pakistani Diaspora to be included in this system This model can be replicated for all countries in the MENA region transforming the way healthcare is delivered and accessed in MENA (and many parts other parts of the emerging world) while promoting gender inclusion in the workforce (for both female doctors and community health workers) Example Rania is a member of DoctHERS-in-the-House. Trained as an OB-GYN, she was forced to quit her career after marriage. She now practices from home. Through vídeo-conferencing, she is beamed into a clinic in Sultanabad, an urban-slum in Karachi. Working with a trained nurse, Ayesha, Rania examines Naz, who is a domestic maid. Ayesha conducts series of antenatal tests (fetal heart monitoring & ultrasound) which Rania sees simultaneously on her monitor. Before DIH, these women would’ve never met. Rania wasn’t allowed to work outside her home let alone in an urban-slum. Ayesha lacked training/skills to run such diagnostic tests independently & Naz, would’ve been at the mercy of quacks, would’ve likely lost out on daily wages given medical complications. (Upon proof-of-concept, this USAID funded Project will be replicated across Pakistan)
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

Rania is a member of DoctHERS-in-the-House. Trained as an OB-GYN, she was forced to quit her career after marriage. She now practices from home. Through vídeo-conferencing, she is beamed into a clinic in Sultanabad, an urban-slum in Karachi. Working with a trained nurse, Ayesha, Rania examines Naz, who is a domestic maid. Ayesha conducts series of antenatal tests (fetal heart monitoring & ultrasound) which Rania sees simultaneously on her monitor. Before DIH, these women would’ve never met. Rania wasn’t allowed to work outside her home let alone in an urban-slum. Ayesha lacked training/skills to run such diagnostic tests independently & Naz, would’ve been at the mercy of quacks, would’ve likely lost out on daily wages given medical complications. (Upon proof-of-concept, this USAID funded Project will be replicated across Pakistan)

Impact: What is the impact of the work to date? Also describe the projected future impact for the coming years.

Supply: Build global network of home-based dithers with initial focus on countries richly populated by Pakistanis. This global network can be scaled to include female doctHERS from countries in MENA (and their corresponding diaspora populations) who are currently excluded from professional workforce. Demand: Challenges that low-income Pakistani women face in accessing health care are similar to those of women in many countries in MENA. We anticipate that the launch of doctHERs-in-the-house in the UAE & Saudi Arabia will create similar demand for services in other MENA countries which will lead to replication in relevant countries. Policy Reform: doctHERs–in-the-house will lobby MENA governments to reimburse for healthcare services provided (directly/indirectly via phone/video and/or assisted by CHWs) & to subsidize payments on behalf of ultra-poor patients.
Sustainability

Financial Sustainability Plan: What is this solution’s plan to ensure financial sustainability?

DIH has a fee-for-service revenue model. DoctHERs will charge 250 Rupees ($2.50) per patient/virtual clinic visit using mobile financial services (patients will be able transfer digital payments in real-time to the doctHERs mobile bank account via a mobile banking service). Of this, 60% (150 Rupees/$1.50) will go to the DoctHER , 20% (50 Rupees/$0.50) will go to the Community Health Worker and 20% (50 Rupees/$0.50) will cover our operating expenses, program costs and yield a projected net operating margin of 5-6%. Operating costs include: • Cost of installing and operating an ICT platform that enables video messaging and mobile, digital payments, • Cost of peripheral diagnostic equipment • Mobile application and software development costs

Marketplace: Who else is addressing the problem outlined here? How does the proposed project differ from these approaches?

Opportunities remain untapped for collaborations across urban/rural divide & underutilized workforce with Key Innovators to ensure we are not working in silos • Aman Health (Tele-healthline, Ambulatory Care, CHWs, Reproductive Health) • Marie Stopes (Reproductive Health, Outpatient-Care) • Naya Jeevan (Health Insurance/Integrated Systems for marginalized) • HealtheConnex (outsource service provider-data interchange) • eHealth Services (telemedicine, medical call centers) DIH strives to create a value-based health marketplace that engages multiple private/public/philanthropic stakeholders & encourages transparent sharing of best practices across sectors. This new health ‘ecosystem’ should result in enhanced 2.0 version of healthcare delivery Also we are not like most local job engines that create portals for women to work-from-home or freelance. We’re a global Independent Physicians Association (IPA) who are disrupting the system and changing how healthcare is accessed & delivered in the industry. We then provide a platform to match-make supply & demand across the hybrid-value-chain (doctors, nurses, CHW, midwives) to both urban and rural women and also include women from the diaspora to participate.
Team

Founding Story

DoctHERs-in-the-house was conceived shortly after I conceived my baby. During my 1st trimester, I had to be on bed-rest and wondered if this would be the end of my career? I didn’t want to have to choose between my family and my career. Luckily my management had a different opinion. Rather than accepting my resignation, my CEO challenged me to think differently and explore new ways to work. Every time my health demanded something (no walking, no elevators, no sick patients, bed-rest) we had to be agile and innovate. My family/friends were amazed at the support I had and the impact I was making and I felt really empowered. I started to engage other female doctors who were not allowed to practice due to their family constraints. I felt tremendous empathy for these professionally stifled women and resolved to create an innovative ‘3rd’ track, an alternate route of delivery quality healthcare at an affordable price . I gave birth to 1 baby girl and 1 doctHERS-in-the-house!
About You
Organization:
doctHERS-in-the-House
About You
First Name

Dr Sara

Last Name

Khurram

About Your Organization
Organization Name

doctHERS-in-the-House

Organization Country

, Karachi

Country where this project is creating social impact

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Project
Year founded

2013

Impact
Impact: What is the impact of the work to date?

Quantitative:

• Through the USAID funded, Sultanabad Community Health Center, 250,000 urban- slum dwellers have had access to quality primary care
• 500 women have been examined in Ante/Post Natal care visits
• Telehealth-facilitated OB/GYN consultations have led to 70+ safe hospital deliveries
• In collaboration with PPAF and HANDS- we are embarking on a pilot to train 1000 Community Health Workers on hand-held diagnostics, guided by home-based doctHERs
• Finalizing 3 MOUs with Partner Organizations to create ‘village specialist’ entrepreneurial opportunities for 3000 rural lady health workers working with DoctHERS
• Creating access to approx 9000 female physicians in Pakistan & diaspora
• Launching a Tech-enabled Community Clinic with DHA Services in Karachi
• Finalizing Media and PR outreach including a national Health TV program series

Qualitative:

• Increase recruitment, retention and re-entry of women into workforce
• Quality and affordable health interventions for marginalized
• Positive social impact for women in context of career, family & community

Barriers: What barriers might hinder the success of your project and how do you plan to overcome them?

• Technology: We rely on connectivity and disruption of service to internet/mobile /electricity could effect services. On the service end- doctHERS are logged into a system that will allow a consultation to be re-routed to another doctHER who is online if needed. We are also testing rural feasibility with our partners and are ensuring that all centers have back-up generators and UPS devices.
• Socio-Culture Resistance: Through mentorship, success stories & ambassadors- create awareness via targeted mediums: women’s morning shows, social media, speaking engagements, Radio, Print
• Professional: Current medical establishment may feel threatened by sudden influx of home-based female doctHERs & disruptive innovations. May try lobbying government for additional regulations/licensing procedures for such practitioners. Low perceived risk given huge mismatch in demand/supply of healthcare
• Trust: Skepticism for new idea in market. Work with existing providers to establish credibility
• Data Security/Integration: Work with IT partners to ensure data security following global standards

Full Impact Potential: What are the main spread strategies moving forward? (Please consider geographic spread, policy reform, and independent replication/adoption of the idea or other mechanisms.)

Supply: Build global network of home-based dithers with initial focus on countries richly populated by Pakistanis. This global network can be scaled to include female doctHERS from countries in MENA (and their corresponding diaspora populations) who are currently excluded from professional workforce.

Demand: Challenges that low-income Pakistani women face in accessing health care are similar to those of women in many countries in MENA. We anticipate that the launch of doctHERs-in-the-house in the UAE & Saudi Arabia will create similar demand for services in other MENA countries which will lead to replication in relevant countries.

Policy Reform: doctHERs–in-the-house will lobby MENA governments to reimburse for healthcare services provided (directly/indirectly via phone/video and/or assisted by CHWs) & to subsidize payments on behalf of ultra-poor patients.

Sustainability
Sustainability Plan: What is this solution’s plan to ensure financial sustainability?

DIH has a fee-for-service revenue model.

DoctHERs will charge 250 Rupees ($2.50) per patient/virtual clinic visit using mobile financial services (patients will be able transfer digital payments in real-time to the doctHERs mobile bank account via a mobile banking service). Of this, 60% (150 Rupees/$1.50) will go to the DoctHER , 20% (50 Rupees/$0.50) will go to the Community Health Worker and 20% (50 Rupees/$0.50) will cover our operating expenses, program costs and yield a projected net operating margin of 5-6%.

Operating costs include:
• Cost of installing and operating an ICT platform that enables video messaging and mobile, digital payments,
• Cost of peripheral diagnostic equipment
• Mobile application and software development costs

Founding Story: Share a story about the "Aha!" moment that led the founder to get started and/or to see the potential for this to succeed.

DoctHERs-in-the-house was conceived shortly after I conceived my baby. During my 1st trimester, I had to be on bed-rest and wondered if this would be the end of my career? I didn’t want to have to choose between my family and my career. Luckily my management had a different opinion. Rather than accepting my resignation, my CEO challenged me to think differently and explore new ways to work. Every time my health demanded something (no walking, no elevators, no sick patients, bed-rest) we had to be agile and innovate. My family/friends were amazed at the support I had and the impact I was making and I felt really empowered. I started to engage other female doctors who were not allowed to practice due to their family constraints. I felt tremendous empathy for these professionally stifled women and resolved to create an innovative ‘3rd’ track, an alternate route of delivery quality healthcare at an affordable price . I gave birth to 1 baby girl and 1 doctHERS-in-the-house!

Partnerships: Tell us about your partnerships.

Partner Organizations:
PPAF (Pakistan Poverty Alleviation Fund)
Naya Jeevan
Hands
APPNA
IMANA

Poverty Eradication Initiative/ Fincon
Consortium of Top Medical Schools in Pakistan
Health TV

Knowledge Bench:
Every Mother Counts
Merck for Moms
Grand Challenges- Saving Lives
Hesperian

Women Powering Work
Is your project targeted at solving any of the following challenges?

Does your project utilize any of the strategies below?

Comments

Brittany Irvine's picture

This is such a thoughtful, health-centric, woman/child/community friendly project.
I am really impressed and would like to be involved in some way if you can think of any way. I am based in Ottawa, Canada and work in Maternal and Infant Health. Good job and great priorities!

All the while, the same Pakistan boasts 85% penetration of mobile access to mobile & internet technology. Given the significant demad-supply mismatch between doctors and patients, it behooves us to question how we can use technology to bridge this gap? http://advanpro.ca/chimney-sweeping-or-cleaning/

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